It's the optician in Hamar, the manual therapist in Bodø, the midwife in Sogn, and the speech therapist in Trondheim. They are part of the Norwegian healthcare system – but rarely part of the national digitalization initiative.

When a politician talks about health digitization, the image is often the same: a doctor in front of a large screen in a hospital. When the Directorate of Health presents strategies and action plans, general practitioner offices and health trusts are central. Both are understandable - that's where the patient volume and the money are - but it's not where the entire healthcare system works.

Norway has over twenty different authorized healthcare professional groups under the Health Personnel Act. Many of them operate in private practice, small clinics, or mobile services. They have the same documentation obligations as doctors, but often far fewer digital tools that are actually built for their daily work.

There are more than you think

If you think of «healthcare professionals,» you probably first think of doctors and nurses. But according to figures from Norwegian Directorate of Health's Register of Authorized Health Personnel Are there also several thousand active healthcare professionals in groups that rarely get attention in the e-health debate:

  • Opticians conducting eye exams and disease screening – according to Norwegian Association of Optometrists There are around 4,000 authorized opticians in Norway.
  • Chiropractors with independent referral rights – Norwegian Chiropractors Association represents around 830 members.
  • Manual therapists who since 2006 have had direct access and referral rights without a doctor's referral.
  • Midwives documenting pregnancy, birth, and postpartum care - many in municipal health centers or private practice.
  • Occupational therapists, speech-language pathologists, audiologists, podiatrists, orthotists, perfusionists, biomedical engineers, and more.

Together, these professions constitute a significant part of the Norwegian healthcare system – and they meet patients every day. Nevertheless, few of them find their workflows represented in the large national digitalization projects.

Why they are forgotten

It's rarely out of malice. It's usually a result of the structure: large digitization programs follow the money and patient volume. Hospitals and general practitioner offices have the largest budgets, the most influential political actors, and the most visible challenges. When a regional health authority chooses an electronic health record system, the requirements are shaped by the needs of the hospitals. When a municipality chooses an EHR, it's general practitioners and the health center that are in focus.

For a private practice chiropractor in Bodø, an optician running their own business, or a speech therapist providing services on assignment, these large purchases often become irrelevant. The tools launched with great fanfare may not necessarily fit into a daily routine where you might see 15–20 patients a day, bill them directly, and document in a system you've chosen yourself. We have previously written about how Chiropractors find that the documentation requirement eats into their treatment time. – and how the same pattern is seen in other professions.

In addition, most of these groups are too small for major suppliers to find it worthwhile to build customized solutions. It becomes a cat-and-mouse situation: no supplier creates tools for occupational therapists because there are too few of them to make it commercially interesting – and the occupational therapists have to manage with generic solutions that are only partially suitable.

Common challenge, different needs

Nevertheless, there is a clear common denominator that unites these professions: they all have a duty to document according to Health Personnel Act §39. This means that every single consultation must be documented in the patient record, regardless of whether you are an optician, midwife, or perfusionist. Missing or inadequate documentation can have consequences, both professionally and legally.

The needs, however, vary greatly:

  • An optician primarily documents numbers and measurements – visual acuity, axis, curvature, various fundus findings.
  • A manual therapist documents functional tests, treatment, and treatment response over time.
  • A midwife documents in close collaboration with the GP and health clinic, and often has to switch between multiple systems.
  • A speech therapist often works with the same patient over a long period and must monitor progress, goals, and interventions.

A commonality for everyone is that record-keeping has become a significant part of the workday, and it's a part of the job that rarely gets external help. We've written about how Physiotherapists are experiencing the same pressure, and it's a parallel that can easily be drawn to all the lesser professions.

What actually helps – across professional groups

The great thing about language as a tool is that it's profession-independent. An optician, a midwife, and a speech therapist speak different professional languages – but they all speak. This is one of the reasons why speech-to-text and automatic structuring tools tend to work more broadly than one might think: they build on what all healthcare professionals are already doing in consultations, namely talking about what they observe and assess.

Tools that work across professions have some common characteristics:

  • They are not tied to one specific journal system.
  • They have technical terms for several fields, not just the dominant one.
  • They work in private practice, not just in hospitals.
  • They don't require a large IT department or a costly implementation.

This is precisely where an opening arises that the major EHR vendors have difficulty filling. Once the digital foundation system is decided for the hospital or municipality, the smaller tools can still be clinician choices—tools that are adapted to the actual workday, regardless of profession. Medivox is one example among several of such a tool, built to function whether you're in a general practitioner's office, an optician's practice, or a speech therapist's clinic. But the point isn't the choice of tool—it's that the smaller professions deserve to be included in the discussion about what constitutes good tools.

Why it matters to the patient

When a professional group is overlooked in digitalization, it often means that the clinician spends more time on documentation and less time with the patient. This means that patient pathways that cross multiple professions – for example, a patient with a musculoskeletal disorder seeing a general practitioner, physical therapist, and chiropractor – experience poorer flow between the providers. It also means that the smaller professions sometimes have to compensate by using their afternoons or weekends to finish documentation.

In a healthcare system where we talk a lot about collaboration and patient-centeredness, it's worth asking: who speaks for the optician? Who speaks for the midwife? Who speaks for the speech therapist? For the most part, they speak for themselves, through their unions and professional publications. But in the grand picture of digitalization, their voices are not as loud as they should be.

Frequently Asked Questions

Does the Health Personnel Act apply to all of these professions?
Yes. The Health Personnel Act and the documentation obligation in Section 39 apply to all authorized health personnel. The profession is irrelevant to the requirement for patient records.

Why don't these groups get their own digitalization programs?
It's largely about economies of scale. Large national initiatives prioritize areas with the highest patient volume. This can change over time, but in the meantime, smaller professions may have to find their own solutions that work across systems.

Can a chiropractor or physical therapist benefit from speech-to-text?
Yes. Speech-to-text is not profession-specific. Treatment notes, functional tests, follow-up plans – everything can be documented verbally and structured afterward. It works for chiropractors, manual therapists, physiotherapists, and others with similar workflows.

Where can I find statistics on authorized healthcare professionals in Norway?
The Directorate of Health leads Healthcare Personnel Register, which is the primary source of authorizations and licenses. Unions also often have updated figures for their members.

Is there a risk that small professions will fall even further behind?
This is a real concern. As large EHR systems are rolled out and become the standard, smaller professions might find that integration possibilities diminish over time. Therefore, it's important that smaller professional groups are also heard when the premises are established – both politically and technically.

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Do you work in a profession rarely heard in the e-health debate? We'd love to hear from you. Contact us – Tell me what challenges you face, and what would actually help your daily life.

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